The Hindu Editorial Analysis
1 December 2025
AIDS and TB Fight — Tamil Nadu Shows the Way Again
(Source – The Hindu, International Edition – Page No. – 8)
Topic : GS Paper II & III – Health, Governance, Disease Eradication, SDGs
Context
On World AIDS Day (December 1), the author revisits India’s journey in tackling HIV/AIDS and Tuberculosis (TB), highlighting how Tamil Nadu’s decentralised, community-based model became a benchmark for other states.
The article connects lessons from India’s AIDS control success to the ongoing fight against TB, especially in integrating digital tools, surveillance, and health system efficiency.
1. Background: India’s AIDS Crisis and Response
- 1980s–1990s: The emergence of HIV/AIDS posed a global health emergency.
- HIV led to immune suppression, causing opportunistic infections such as tuberculosis and diarrhoea.
- India recorded increasing HIV prevalence (below 1% but widespread by 1990s).
- Transmission: Primarily via unprotected heterosexual contact and needle-sharing in the northeast.
2. The Tamil Nadu State AIDS Control Society (TNSACS) Model
- The Government of India launched the National AIDS Control Project (NACP) in 1992 with World Bank support.
- Tamil Nadu innovated by creating a Registered Society (TNSACS) to manage funds independently — enhancing flexibility and accountability.
- This model’s success:
- Targeted campaigns led to a steep fall in new infections.
- Tamil Nadu’s HIV rate fell from 0.54% (2000) to 0.22% (2020) — one of the sharpest declines in India.
- The model was replicated nationwide under NACP-II (1997–2002).
3. Linking AIDS and TB: The Double Burden
- TB is the most common opportunistic infection among HIV-positive people, responsible for ~25% of AIDS deaths in India.
- India accounts for 25% of global TB patients and 25% of multidrug-resistant TB (MDR-TB) cases.
- Hence, integrating HIV and TB surveillance, testing, and treatment is vital for achieving health-related SDGs.
4. Tamil Nadu’s Leadership in TB Control
- India aims to eliminate TB by 2025, five years ahead of the global WHO target (2030).
- Tamil Nadu integrates TB and HIV management via:
- Digital platforms for patient screening and tracking.
- State-wide linkage between AIDS and TB control cells.
- Community-based awareness and early diagnosis.
- ICMR–NIE collaboration supports Tamil Nadu in reducing TB mortality through rapid testing, treatment adherence, and nutrition support.
5. National-Level Lessons and Replication
- Five states — Uttar Pradesh, Maharashtra, Madhya Pradesh, Bihar, and Rajasthan — contribute 56% of India’s TB burden (2024).
- The Tamil Nadu model demonstrates how decentralised governance, strong public health delivery, and digital tracking can reduce both AIDS and TB fatalities.
- The Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA) is now expanding this model nationwide, combining corporate social responsibility (CSR) and public participation.
6. Key Takeaways for Policy
- Integrated disease surveillance (HIV–TB nexus) ensures efficient use of health infrastructure.
- Autonomous state-level societies improve accountability and speed of fund utilisation.
- Community engagement + digital monitoring are the cornerstones of effective epidemic control.
- Tamil Nadu’s consistent success underlines the importance of federal flexibility and innovation at state level.
Conclusion
“Tamil Nadu’s decentralised AIDS model not only curbed HIV but now guides India’s path toward TB elimination.”
The state’s approach — combining autonomy, digitalisation, and social mobilisation — is a replicable template for tackling other public health challenges like vector-borne diseases and antimicrobial resistance.
India’s goal of ‘TB-Mukt Bharat by 2025’ can be achieved only if other states adopt Tamil Nadu’s evidence-driven and community-led approach.